LEAFLET: INFORMATION FOR USER

Moldamin® 1,200,000 IU, powder for suspension for injection

Benzathine benzylpenicillin

Read all of this leaflet carefully before you start taking this medicine.

-Keep this leaflet. You may need to read it again.

-If you have any further questions, ask your doctor or pharmacist.

-This medicine has been prescribed for you. Do not pass it on to others. It may do harm them, even if their symptoms are the same as yours.

-If any of the side effects gets serious, or if you notice any side effects not listed in this leaflet, please tell your doctor.

In this leaflet:

  1. What Moldamin® is and what it is used for
  2. Before you useMoldamin®
  3. How to use Moldamin®
  4. Possible side effects
  5. How to store Moldamin®
  6. Further information
  1. What Moldamin®is and what it is used for

Moldamin® belongs to the group of the medicines called beta-lactam antibacterials, penicillins sensitive to beta-lactamase.

Moldamin® works against of some penicillin-sensitive germs that cause the upper respiratory tract infections. It is indicated in prophylaxis of streptococcalinfection in the patients with acute articular rheumatism and syphilis.

  1. Before you useMoldamin®

You should not use Moldamin®:

-if you are allergic (hypersensitive) to benzathine benzylpenicillin and other beta-lactam antibacterials or other components of Moldamin®.

Take special care with Moldamin®

-if you have allergic reactions to any medicine;

-if you have kidney disease or the affections that cause the water retention;

-if you remark the acceleration of intestinal transit;

-if you remark the emergence of a new infection.

Moldamin® may cause false positive results of some tests of sugar determination or protein level in urine.

Using of other medicines

Please tell your doctor or pharmacist if you are taking or have recently taken any other medicine, including any that you buy without a prescription.

Concurrent use of Moldamin® with other medicines may change reciprocally their mode of action. Ask your doctor or pharmacist if you take other medicines as: tetracycline, probenecid, acetylsalicylic acid, oral anticoagulants and contraceptives.

Pregnancy and breast-feeding

If you are pregnant or breast-feeding, tell your doctorbefore taking any medicine.

Driving and using machines

Moldamin®has no influence on the capacity to drive or use machines.

Important information regarding some components of Moldamin®

Moldamin® contains sodium 0.30 mEq (7 mg)/vial; basically it contains no sodium.

  1. How to useMoldamin®

Always use Moldamin® following carefully your doctor’s instructions. You should contact your doctor or pharmacist if you have any doubts.

Moldamin® should be administered by your doctor or nurse.

- it is administered by injection;

- it should be administered by deep intramuscular injection in a muscle with large surface.

The dose administered by your doctor depends on the type and severity of your infection. The dose is correlated with your body weight, too. Your doctor will explain to you this thing. The usual dosages are the followings:

Prophylaxis of streptococcal infections

Children

In accordance with the age and body weight, the following dosages are recommended:

Children 2-11 years old, body weight < 30 kg: 300,000 IU-600,000 IU in a single dose, deep intramuscular injection;

Teenagers: body weight > 30 kg: 900,000 IU in a single dose, deep intramuscular injection.

Adults

1,2000,00 IU in a single dose, deep intramuscular injection.

Secondary prophylaxis

1,200,000 I.U. in a single dose, every 3-4 weeks or 600,000 IU every 2 weeks; it lasts at least 5 years from AAR attack up to 20-25 years old.

Syphilis

Primary, secondary and latent (lasting less than 1 year) syphilis: a single dosage of 2,400,000 IU, deep intramuscular injection, half dose will be injected into each buttock.

Pregnant women with primary or secondary syphilis: a dosage of 2,400,000 IU, this dose is repeated after one week.

Tertiary or latent syphilis (lasting over one year): a dosage of 2,400,000 IU, deep intramuscular injection, every 7 days, for 3 weeks.

In case of seropositive primary syphilis, secondary florid syphilis, early latent syphilis, late latent syphilis and tertiary syphilis, the preparation is done by administering increasing doses of crystalline penicillin in order to prevent Jarisch-Herxhimer reaction. Then, Moldamin® is administered by deep intramuscular injection.

Congenital syphilis: in children aged 6 months to 2 years, the recommended dosage is 50,000-100,000 IU/kg (maximum dose: 2,400,000 IU).

In children 2-12 years old, the recommended dose is 50,000-100,000 IU/kg (maximum dosage: 2,400,000 IU).

If you use more Moldamin® than you should

Using more of any medicine may cause serious consequences. Unusual neurological manifestations or convulsions may occur. In this case, contact the Emergency Department of your nearest hospital or ask your doctor straight away.

If you forget to use Moldamin®

It is important to receive all doses according to schedule of drug administration.

If you fail to take a dose, ask your doctor immediately.

If you stop using Moldamin®

It is important to receive all doses for the full time of therapy. If you stop the schedule of drug administration, your disease may worsen or return.

If you have additional questions regarding this medicine, please ask your doctor or pharmacist.

  1. Possible side-effects

Like all medicines, Moldamin® can cause undesirable effects, although not everybody gets them.

Blood and lymphatic system disorders

- hemolytic anemia, leucopenia, thrombocytopenia.

Immune system disorders

-allergic reactions, particularly in patients which experienced allergy to penicillins previously, or with history of allergy, asthma or urticaria. These reactions include: skin eruptions (maculopapular dermatitis, exfoliative dermatitis), urticaria, laryngeal edema, fever, eosinophilia, and anaphylaxis, including shock and death. Jarish-Herxheimer reaction may occur in syphilis treatment. Lymphadenopathy and fever may be reported, too.

Psychiatric disorders

-irritability, confusion, anxiety, euphoria.

Nervous system disorders

-neuropathy, shiver, dizziness, somnolence, coma.

Respiratory, thoracic and mediastinal disorders

-hypoxia, respiratory arrest or dyspnea

Gastrointestinal disorders

-nausea, vomiting, blood in the stool, intestinal necrosis, pseudo-membranous colitis.

Cardiovascular disorders

-cardiac arrest, hypotension, tachycardia, palpitations, pulmonary hypertension, pulmonary embolism, vasovagal reaction, stroke, syncope.

Metabolism and nutrition disorders

-increase of creatininemia and serum levels of ASAT .

Skin and subcutaneous tissue disorders

-excessive sweating.

Musculoskeletal and connective tissue disorders

-joint pains, periostitis, exacerbation of arthritis, rhabdomyolysis.

Renal and urinary disorders

-blood and proteins in urine, acute interstitial nephritis, renal insufficiency.

Reproductive system and breast disorders

-impotence, priapism.

Common disorders and disorders at the site of injection

- the following symptoms may occur at the site of injection: pain, inflammation, swelling, nodules, abscess, necrosis, oedema, bleeding, cellulite, hypersensitivity, atrophy, contusion and ulcer.

If any of these side-effects becomes severe or you notice other side-effects not specified in this leaflet, please tell your doctor or pharmacist.

  1. How to storeMoldamin®

Keep out of the reach and sight of children.

This product should be stored in the original package, at temperatures below 25 0C.

Do not use Moldamin® after the expiry date printed on the package (EXP). The expiry date refers to the last day of that month.

Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose medicines no longer required. These measures will help to protect the environment.

  1. Further information

What Moldamin® contains:

-The active substance is benzathine benzylpenicillin. One vial of powder for suspension for injection contains 1,200,000 IU of benzathine benzylpenicillin.

-The other ingredients are: lecithin, sodium citrate.

What Moldamin® looks like and contents of the pack

Moldamin® is a white to almost white powder.

A colorless glass vial of 10 ml, closed with a rubber stopper and sealed with an aluminum cap, containing powder for suspension for I.M. injection.

One box contains 50 (fifty) colorless glass vials of 10 ml, closed with a rubber stopper sealed with an aluminum cap, containing powder for suspension for I.M. injection.

One box contains 100 (one hundred) colorless glass vials of 10 ml, closed with a rubber stopper sealed with an aluminum cap, containing powder for suspension for I.M. injection.

Marketing Authorization holder and drug manufacturer

Antibiotice S.A.

1, Valea Lupului Street, 707410 Iasi, Romania, E.U.

This leaflet was last approved in March 2010

The following information is intended only for doctors and medical staff:

Moldamin® should be administered by deep injection, into a muscle (intramuscular administration) by skilled health personnel.

The content of one vial of 1,200,000 I.U. should be dissolved in 4 ml of water for injections, by shaking.

It should not be injected into a vein (intravenous administration) or near a nerve. Subcutaneous injection or into superficial muscle layers is not recommended because it can result in pain and nodules.

In children, Moldamin® is administered by deep intramuscular injections into upper outerquadrant of buttock area, or mid-lateral aspect of the thigh (in infants and small children the last part may be preferable).

Into mid-lateral aspect of the thigh, repeated intramuscular administration should avoid as the risk of atrophy or fibrosis of the muscle can occur in new-born children and infants particularly.

The administration should discontinue when severe acute pain occur at the injection site. Pain and nodules that occur as result of improper and superficial administration may be improved by applying an ice pack.

Only freshly prepared suspension should be injected. The reconstituted medicine is for a single use only and any unused solution should be discarded.

Any complaint should be accompanied by this leaflet.